{"id":825,"date":"2023-12-20T02:40:00","date_gmt":"2023-12-20T02:40:00","guid":{"rendered":"https:\/\/drmirkin.com\/2017\/12\/31\/low-vitamin-d-predicts-risk-for-injuries\/"},"modified":"2023-12-23T00:53:16","modified_gmt":"2023-12-23T00:53:16","slug":"low-vitamin-d-predicts-risk-for-injuries","status":"publish","type":"post","link":"http:\/\/drmirkin.com\/?p=825","title":{"rendered":"Low Vitamin D Increases Risk for Sports Injuries"},"content":{"rendered":"

If you suffer muscle or tendon injuries, particularly during the winter or early spring, ask your doctor to order a blood test for hydroxy vitamin D. If it is below 30 ng\/mL, you probably need more exposure to sunlight or you need to take vitamin D pills. \u00a0\u00a0A review of studies on sports injuries found that lack of vitamin D can be a major cause of recurrent winter-time injuries in athletes and exercisers (Physical Activity and Nutrition,<\/em> June 30, 2021;25(2):20-25).\u00a0 In a study of 214 prospective National Football League players, 86 percent of those who missed college games because of lower leg injuries were vitamin D deficient, and 73 percent of those who were deficient in vitamin D had severe lower leg injuries compared to only 40 percent of those who were not deficient in vitamin D (Arthroscopy<\/em>, Dec. 21, 2017). Low levels of vitamin D can reduce strength and endurance (Sci Sports Exerc<\/em>, 2018;50:2555-64) and increase injury risk (J Sports Med Phys Fitness,<\/em>\u00a02019;59:693-9).<\/p>\n

My Personal Experience<\/strong>
\nDuring my competitive running career, I spent more time injured than training because of wintertime muscle injuries in Boston and Washington, DC. Many years later, I found the cause: my wintertime vitamin D3 blood level was below 20 ng\/mL (normal is >30 ng\/mL).\u00a0 I now know that people who are genetically susceptible to vitamin D deficiency are the ones most likely to suffer muscle weakness, injuries and poor athletic performance (Lancet<\/em>, 2010 Jul 17;376(9736): 180\u2013188). I believe that sunlight offers benefits that cannot be obtained from vitamin D pills.<\/p>\n

Other Conditions Associated with Vitamin D Deficiency<\/strong>
\nAbout 40 percent of North Americans have vitamin D levels below 20 ng\/mL, which makes them deficient by most standards (Nutr Res<\/em>, 2011 Jan;31(1):48-54). Vitamin D deficiency is associated with increased risk for developing many diseases (Aging Dis<\/em>, May 2017;8(3):346\u2013353), including:
\n\u2022 osteoporosis, broken bones and falls
\n\u2022 kidney disease and kidney stones
\n\u2022 fatty liver and other chronic liver diseases
\n\u2022 heart disease and high blood pressure
\n\u2022 Type II diabetes (Annals of Int Med,<\/em>\u00a0Feb 7, 2023)
\n\u2022 severe infections such as COVID-19 and hepatitis C
\n\u2022 multiple sclerosis
\n\u2022 psoriasis
\n\u2022 osteoarthritis
\n\u2022 autoimmune diseases
\n\u2022 colon, prostate and breast cancers
\n\u2022 muscle pain and weakness
\n\u2022 ulcerative colitis or Crohn\u2019s disease
\n\u2022 depression and other psychiatric disorders<\/p>\n

No Need to Take More than 1000 IU of Vitamin D<\/strong>
\nThere is no proven benefit from taking doses of vitamin D greater than 1000 IU\/day or having very high blood levels (>30ng\/mL). Raising blood levels of hydroxy vitamin D from 20 to 30 ng\/ml with high doses of vitamin D pills increases calcium absorption by only one percent and does not increase bone mineral density or physical function, compared with placebo (Curr Opin Endocrinol Diabetes Obes<\/em>, Dec 2016;23(6):440-444). High doses of vitamin D can cause nausea, constipation, kidney stones, frequent urination, muscle weakness, irregular heartbeats and possibly arteriosclerosis. See my report on Vitamin D Research<\/a><\/p>\n

Confusion about Vitamin D Deficiency<\/strong>
\nIt is difficult for doctors to identify patients with vitamin D deficiency because most commercial laboratories do not offer a test for the active form of vitamin 1,25 dihydroxy vitamin D. Instead, laboratories measure an inactive form called hydroxy vitamin D. The massive doses of vitamin D recommended by some doctors do not raise the active form of vitamin D because your own body tries to protect you from poisoning by breaking down the active form. You cannot develop vitamin D poisoning from too much sunlight because sunlight breaks down vitamin D just as it helps your body to make it, so as you keep exposing your skin to sunlight, blood levels reach a certain level and do not rise higher. Massive doses of vitamin D pills such as 150,000 IU every three months fail to raise blood levels of the active 1,25 hydroxy vitamin D (J Adolesc Health<\/em>, Jul 2015;57(1):19-23).<\/p>\n

Many studies show that people with dark skin have lower levels of the inactive form of vitamin D. It’s a different story when doctors measure blood levels of the active form of vitamin D. People with dark skin are able to use a much higher proportion of the active form of vitamin D (N Engl J Med<\/em>, Nov 21, 2013;369(21):1991-2000).<\/p>\n

You probably do not need to take vitamin D pills if your blood level of hydroxy vitamin D is above 30 ng\/ml unless you have a condition that your doctor feels puts you at increased risk for the signs and symptoms of a deficiency. You can take up to 1000 IU\/day of vitamin D pills if your blood levels are below 30 ng\/ml. Most researchers and clinicians now feel that, with few exceptions, high doses of vitamin D are not beneficial and are potentially harmful. People who could possibly benefit from treating low blood levels of hydroxy vitamin D (<30 ng\/ml) include those who:
\n\u2022 are inactive and do not go outdoors
\n\u2022 suffer from generalized muscle and joint pain
\n\u2022 are athletes with recurrent injuries and decreased performance
\n\u2022 have weak bones (osteoporosis)
\n\u2022 are diabetic, particularly if LDL cholesterol is over 100
\n\u2022 have an auto-immune disease
\n\u2022 are critically ill or debilitated
\n\u2022 suffer from muscle pain from taking statin drugs<\/p>\n

My Recommendations<\/strong>
\nIf you are an exerciser who suffers from muscle pain, injuries or weakness:
\n\u2022 Get your hydroxy vitamin D level checked. That is the only available dependable test. If it is below 30 ng\/ml (75 nmol\/L), you may be deficient. You can try taking vitamin D3 at a dose of up to 2000 IU\/day for a month.<\/p>\n

\u2022 If that does not bring your hydroxy vitamin D level to normal, you can check with your doctor about taking higher doses. However, taking more than 2000 IU\/day is highly controversial.<\/p>\n

\u2022 Some people will have their hydroxy vitamin D levels above a normal 30 ng\/ml and still suffer from muscle weakness, fatigue, pain and injuries, and these people may benefit from exposure to sunlight.<\/p>\n

\u2022 Since skin cancer is caused by cumulative exposure to sunlight over a lifetime, you should restrict exposure to sunlight on your most-often sun-exposed areas: head, face, top of ears, arms and hands. Try exposing your legs and bathing suit areas, and be careful to avoid sunburn.<\/p>\n","protected":false},"excerpt":{"rendered":"

If you suffer muscle or tendon injuries, particularly during the winter or early spring, ask your doctor to order a blood test for hydroxy vitamin D. If it is below 30 ng\/mL, you probably need more exposure to sunlight or you need to take vitamin D pills. \u00a0\u00a0A review of sports injuries showed that lack of vitamin D can be a major cause of recurrent winter-time injuries in athletes and exercisers<\/p>\n","protected":false},"author":1,"featured_media":1008,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[6],"tags":[1061,136,438],"class_list":["post-825","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fitness","tag-sports-injuries","tag-vitamin-d","tag-vitamin-d-deficiency"],"_links":{"self":[{"href":"http:\/\/drmirkin.com\/index.php?rest_route=\/wp\/v2\/posts\/825","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/drmirkin.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/drmirkin.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/drmirkin.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/drmirkin.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=825"}],"version-history":[{"count":0,"href":"http:\/\/drmirkin.com\/index.php?rest_route=\/wp\/v2\/posts\/825\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/drmirkin.com\/index.php?rest_route=\/wp\/v2\/media\/1008"}],"wp:attachment":[{"href":"http:\/\/drmirkin.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=825"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/drmirkin.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=825"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/drmirkin.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=825"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}